Endler Margit, Saltvedt Sissel, Eweida Mohamed, Åkerud Helena
Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
Department of Obstetrics and Gynecology, Södersjukhuset, Sjukhusbacken 10, Stockholm, 118 83, Sweden.
BMC Pregnancy Childbirth. 2016 Dec 6;16(1):384. doi: 10.1186/s12884-016-1135-1.
Retained placenta is associated with severe postpartum hemorrhage. Its etiology is unknown and its biochemistry has not been studied. We aimed to assess whether levels of the antioxidative enzyme Glutathione Peroxidase 1 (GPX1) and the transcription factor Nuclear Factor κβ (NFκβ), as markers of oxidative stress and inflammation, were affected in retained placentas compared to spontaneously released placentas from otherwise normal full term pregnancies.
In a pilot study we assessed concentrations of GPX1 by ELISA and gene (mRNA) expression of GPX1, NFκβ and its inhibitor Iκβα, by quantitative real-time-PCR in periumbilical and peripheral samples from retained (n = 29) and non-retained (n = 31) placental tissue.
Median periumbilical GPX1 concentrations were 13.32 ng/ml in retained placentas and 17.96 ng/ml in non-retained placentas (p = 0.22), peripheral concentrations were 13.27 ng/ml and 19.09 ng/ml (p = 0.08). Retained placental tissue was more likely to have a low GPX1 protein concentration (OR 3.82, p = 0.02 for periumbilical and OR 3.95, p = 0.02 for peripheral samples). Median periumbilical GPX1 gene expressions were 1.13 for retained placentas and 0.88 for non-retained placentas (p = 0.08), peripheral expression was 1.32 and 1.18 (p = 0.46). Gene expressions of NFκβ and Iκβα were not significantly different between retained and non-retained placental tissue.
Women with retained placenta were more likely to have a low level of GPX1 protein concentration in placental tissue compared to women without retained placenta and retained placental tissue showed a tendency of lower median concentrations of GPX1 protein expression. This may indicate decreased antioxidative capacity as a component in this disorder but requires a larger sample to corroborate results.
胎盘滞留与严重产后出血相关。其病因不明，生物化学机制尚未得到研究。我们旨在评估作为氧化应激和炎症标志物的抗氧化酶谷胱甘肽过氧化物酶1（GPX1）和转录因子核因子κβ（NFκβ）的水平在胎盘滞留时与正常足月妊娠自然娩出的胎盘相比是否受到影响。
在一项初步研究中，我们通过酶联免疫吸附测定法（ELISA）评估GPX1的浓度，并通过定量实时聚合酶链反应（qRT-PCR）检测胎盘滞留组（n = 29）和非滞留组（n = 31）胎盘组织的脐周和外周样本中GPX1、NFκβ及其抑制剂Iκβα的基因（mRNA）表达。
胎盘滞留组脐周GPX1浓度中位数为13.32 ng/ml，非滞留组为17.96 ng/ml（p = 0.22），外周浓度分别为13.27 ng/ml和19.09 ng/ml（p = 0.08）。胎盘滞留组织更有可能具有低水平的GPX1蛋白浓度（脐周样本的比值比为3.82，p = 0.02；外周样本的比值比为3.95，p = 0.02）。胎盘滞留组脐周GPX1基因表达中位数为1.13，非滞留组为0.88（p = 0.08），外周表达分别为1.32和1.18（p = 0.46）。胎盘滞留组织与非滞留组织之间NFκβ和Iκβα的基因表达无显著差异。
与无胎盘滞留的女性相比，胎盘滞留女性胎盘组织中GPX1蛋白浓度更有可能较低，且胎盘滞留组织中GPX1蛋白表达的中位数浓度有降低趋势。这可能表明抗氧化能力下降是该病症的一个组成部分，但需要更大样本量来证实结果。
